ObjectiveWe investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care.MethodsPain Visual-Analogue-Scale (range 1–5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3.85± 1.39; p = 0.036) even though pain anticipated prior to procedures was similar (~3).FindingsChildren who underwent the first procedure with clown-care reported lower pain even after they crossed-over to the following procedure which was standard (p = 0.048). Carryover effect was more prominent in injection-naïve children (p = 0.019) and during multiple procedures (p = 0.009). Prior pain experience correlated with pain in subsequent procedures only when first experience was standard-care (p = 0.001).ConclusionsClown-care alleviated pain sensation during Botulinum-toxin injections and initial clown-care experience reduced pain during subsequent injections even though clowns were not present.Trial registrationclinicaltrials.gov ID # NCT01377883.
Risk taking is commonly attributed to individuals with attention deficit hyperactivity disorder (ADHD). This study investigated whether adolescents with ADHD would choose to take greater risks on a probabilistic task in which contingencies are explicitly presented. Adolescents with and without ADHD, aged 13 to 18 years, performed a modified version of the Cambridge Gambling Task. The subjects with ADHD risked smaller sums and chose the unfavorable outcomes more frequently than did the controls but had the same speed of decision and risk adjustment. The results indicate that their poor decisions were not due to impulsivity or insensitivity to the concept of probability and that increased risk taking is not always associated with ADHD. Moreover, in situations that do not demand learning of contingencies, ADHD may be associated with decreased, rather than increased, risk taking.
The centrality of executive function deficits (EFD) in attention deficit/ hyperactivity disorder (ADHD) is well accepted albeit EFD is not synonymous with ADHD. The purpose of the present study was to examine the extent to which ADHD and EF overlap and to validate the Hebrew version of the Behavioral Rating Inventory of Executive Functions (BRIEF). Parents of 178 children with and without ADHD completed the BRIEF and the ADHD-Rating Scale. Significant differences were found between groups on each scale even after controlling for the other scale. Internal consistency analysis supported the reliability of the Hebrew version of the BRIEF. We conclude that ADHD and Executive Dysfunctions do not completely overlap.
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